Clinic of Orthopedics, Pediatric Orthopedics Medical University of Lodz, Lodz, Poland.
J Pediatr Orthop B. 2023 May 1;32(3):221-226. doi: 10.1097/BPB.0000000000000872. Epub 2021 May 20.
Cerebral palsy in children, which is the result of a nonprogressing damage to the central nervous system, causes motor and posture disorders that change with age. The level of child activity correlates with the hip dislocation risk. It most often affects nonwalking patients and those with tetraparesis or oblique pelvis. The aim of the study was to assess the effectiveness and clinical value of Dega pelvic osteotomy with accompanying directional femoral bone osteotomy after minimum of 20 years from surgery of patients with cerebral palsy. The conducted research was retrospective and concerned the children operated at our Hospital. The assessment was carried out in 346 children with spastic hip during the years 1993-2000. The inclusion criteria were applied: unilateral dislocation of the hip, the observation period of at least 20 years, pelvic osteotomy by Dega method and combined with varus derotation femur osteotomy. The analysis involved fifteen patients. The follow-up period was minimum 20 years (20-27 years). The average migration percentage decreased from 88% down to 25%, and an improved range of mobility was observed in the operated joint after surgery. However, the range of mobility was again significantly reduced during the last control examination after a minimum of 20 years. In all hips, the degenerative joint disease was present. Pelvic transiliac osteotomy, according to Dega, with VDRO, ensures very effective correction of the deficit in femoral head coverage by the acetabulum in the upper, lateral and posterior parts. However, it does not prevent the development of the early degenerative disease of the joint.
儿童脑瘫是一种中枢神经系统进行性损伤的结果，导致运动和姿势障碍，这些障碍会随年龄而变化。儿童的活动水平与髋关节脱位的风险相关。它最常影响非行走患者以及四肢瘫痪或斜骨盆患者。本研究的目的是评估在脑瘫患者手术后至少 20 年，对接受 Dega 骨盆截骨术和伴随的定向股骨截骨术的患者的疗效和临床价值。所进行的研究是回顾性的，涉及在我们医院接受手术的儿童。在 1993 年至 2000 年期间，对 346 例痉挛性髋关节患儿进行了评估。纳入标准为：单侧髋关节脱位，观察期至少 20 年，采用 Dega 方法行骨盆截骨术，联合内旋股骨截骨术。分析涉及 15 名患者。随访时间至少 20 年（20-27 年）。平均迁移百分比从 88%下降到 25%，术后手术关节的活动范围有所改善。然而，在至少 20 年的最后一次对照检查中，活动范围再次显著减少。所有髋关节均存在退行性关节疾病。根据 Dega 进行的骨盆髂骨截骨术联合 VDRO 可非常有效地纠正髋臼对股骨头覆盖的不足，特别是在上、外侧和后部分。然而，它并不能防止关节早期退行性疾病的发展。
